Androgen Dependent Alopecia

What is Androgen Dependent Alopecia?

It’s normal to lose hair. In fact, humans can lose anywhere between 50 and 100 hairs a day without noticing any change. However, if you start to lose more hair than usual, or you notice that your hair is thinning and not growing back, you may have a medical condition known as Androgen Dependent Alopecia.

Androgen Dependent Alopecia, often called Female Pattern Baldness, Female Pattern Thinning or Female Pattern Hair Loss, is a condition that affects hair density on the crown and top of the scalp. Compared to the head’s sides and back, the hair can feel much finer and look almost transparent as the scalp becomes more visible.

The onset of Androgen Dependent Alopecia is usually gradual, although some individuals report a more sudden loss.

Who can have Androgen Dependent Alopecia?

Interestingly, this condition affects both men and women. Although it tends to be associated with old age, it can affect people of all ages, typically from puberty onwards.

In men, this type of hair loss usually begins at the temples and the hairline. As the hair on the hairline recedes, an ‘M’ shape forms at the top of the head. Although men can lose all their hair and become completely bald, women rarely go bald or experience a receding hairline.

Hair loss in women often has a greater emotional impact than hair loss does on men due to the expectations of women in society. Alopecia can be very distressing to experience and sometimes has long-lasting effects on a woman’s emotional well-being and quality of life. All women will experience one of the many types of hair loss in their lives and one in four will develop Androgen Dependent Alopecia.

What causes Androgen Dependent Alopecia?

Male and Female Pattern Thinning is often associated with medical conditions, such as a hormone imbalance, or in women, Polycystic Ovary Syndrome (PCOS). However, in most cases, this hair loss condition is hereditary and is not due to increased hormone levels.

Androgen Dependent Alopecia can run in the family and is often triggered by circulating male hormones (androgens). The hair follicles become sensitive to these androgens, causing the affected follicles to miniaturise, or get smaller. The terminal mature hairs gradually develop into finer and smaller vellus hairs – just like the fine hair we have all over our bodies. 

Hair loss can also be caused by:

  • Physical or emotional stress
  • An illness
  • Cancer treatment
  • Weight loss
  • Iron deficiency

Symptoms of Androgenic Alopecia / Pattern Hair Thinning

Patients who come to see me with Female Pattern Thinning complain that their hair lacks body, that their scalp is increasingly more visible and that it is embarrassing and very upsetting. The most common symptoms are:

  • In women: the hair on the top and crown of the scalp becomes thinner. This usually starts at the parting of the hair, which gradually becomes wider. 
  • In men: The front hairline and hair at the temples thins or recedes in an ‘M’ shape.

Treating Androgen-Dependent Alopecia

In most cases, Androgen Dependent Alopecia in women can be treated, and increased hair density can be achieved. I will follow the treatment plan below:

  • Firstly, other causes of hair loss must be ruled out, such as thyroid disease or iron deficiency
  • I will then look at the appearance and pattern of your hair loss and your medical history
  • Where appropriate for the individual being treated, I use an agent to minimise and, in some cases, block the causative androgen without attempting to alter their hormone levels.

Contrary to some medical opinions, certain HRT (Hormone Replacement Therapy) and oral contraceptive pills can exacerbate rather than help this condition. It is essential that women who are considering these medications receive proper medical advice as to which are the most appropriate. For this reason, I often work alongside other medical disciplines, such as Endocrinologists and Gynaecologists, and I am endorsed by many of them.

FAQs about Pattern Hair Loss

Can NHS treatment help Androgen-dependent alopecia?

There are currently no Trichologists available on the NHS, and most Dermatologists cannot accurately diagnose this condition and advise how to treat it and prevent it from worsening. Your GP may mention using Regaine (available from most pharmacies). Still, in my opinion, this is insufficient when used alone, both to block the androgens and stimulate a sustainable level of regrowth for the patient.

Can alternative treatments help Androgen Dependent Alopecia?

In my experience, no. While I massively support the use of alternative therapies where appropriate, in the case of this hormone-related condition, they are insufficient. Anti-androgen products such as saw palmetto and green tea leaf extract are included within the alternative treatments category; however, these alone will not suffice.

How long does it take for Androgen-dependent alopecia to progress?

This varies from person to person, depending on other health factors, such as whether the patient has a hair-shedding or a pre-existing scalp condition. As an approximate guide, I usually find the trigger for this two to five years before the patient notices the “see-through” stage.

Can you prevent Androgen-dependent alopecia?

Sadly, you can not treat Androgen Dependent Alopecia before it’s diagnosed, but there are many things you can do to keep your hair and scalp healthy if you feel someone in the family has this. The condition is based on the recessive gene you may not always inherit.

What does a session with you involve?

In our first initial consultation, which usually lasts one hour, I will ask you a series of questions, including the names of any medications and supplements you take, what you use on your hair, your medical history, your diet and nutrition and I will conduct a complete hair and scalp examination. I will sometimes use a dermoscopy tool to examine your hair’s formation, determine any possible scalp condition and take some photos.

What do patients say about our services?

Shuna has been wonderful. A few years ago I became aware that the overall density of my hair had become significantly thinner than it used to be. During my teenage years I had fairly thick hair, but during my degree I had dealt with excessive levels of stress and terrible nutrition. This had left my hair depleted and thin by the time I was 21, and realising how much hair I had lost, and was continuing to lose, made me terrified of doing anything to it. I lacked so much confidence because of how I thought it looked, that seeing a reflection or having a photo taken became my biggest fear.

Miss H visited me after suffering from Female Pattern Thinning. You can read her full testimonial here.